Reports of
faulty gas pedals, obstructive floor carpets and failing breaks in Toyota and
Lexus vehicles generated an uproar across major media networks. For the 4 year
period starting in 2006, the National Highway Traffic Safety Administration (NHTSA)
had reported 5 deaths, 17 injuries and 13 crashes, and an additional 29 deaths
between 2000 and 2005. There was no hesitation among the networks and federal
officials to demonize Toyota for knowingly risk the lives of people solely to
empty its dealership lots. Even Congress quickly called for a Congressional
investigation, and Toyota took upon itself the responsibility to recall over 8
million vehicles.

During the
same 4 year period while NHTSA was collecting crash data on Toyota’s lemons, the
Centers for Disease Control (CDC)’s Vaccine Adverse Events Reporting System
(VAERS) database was gathering casualty data following vaccinations with Merck’s
human papilloma virus (HPV) vaccine, Gardasil. And it was clear that Merck was
far ahead and winning its race against Toyota for the Lemon of the Decade
Award. Since Gardasil’s launch in 2006, the vaccine has been responsible for 66
deaths and over 17,700 medical injuries of young girls, as young as 11 years
old. Six percent of reported events, or 1,100 girls, were serious enough to
require emergency hospitalization.

Unfortunately, vaccine injuries are not reported immediately and thoroughly as
automobile accidents and deaths. There are no vaccine police rushing to the
scene of vaccine accidents to investigate the incidents and to record injuries
and fatalities accurately. Consequently, only a fraction of vaccine adverse
events are reported by pediatricians, physicians, medical clinics and hospitals,
and make their way eventually into the VAERS database. Few parents even know
such a reporting system exists.

During a
Progressive Radio Network interview with Cindy Bevington, who has investigated
and reported about Gardasil extensively, she note on the hundreds and hundreds
of emails she receives from girls, mothers and doctors around the US and other
countries complaining about the HPV vaccines. Often she receives parent requests
“begging” for help because their pediatricians and physicians refuse to report
their daughters’ adverse events as vaccine related.

According
to the CDC’s own admission, only 10 percent of adverse events get listed on
VAERS. This very conservative figure has been refuted by independent analyses;
actual records can be as low as 1 percent of all actual negative reactions for
any given vaccine. It is therefore realistic to suspect that Gardasil is
associated with between 177,000 and 1.7 million adverse effects among vaccinated
American girls and young women.

According
to the website Medalerts.org, a young woman vaccinated with Gardasil is ten
times more likely to file a VAERS report compared to an influenza vaccination.
HPV vaccines now account for 20 percent of all vaccine side effects aside from
the H1N1 swine flu vaccine. America’s daughters are twice as likely to have an
emergency room visit. They are four times more likely to have a death sentence,
five times more likely to receive a report of “did not recover,” and seven times
more likely be pronounced “disabled.”

Besides the
66 deaths, Gardasil’s serious side effects now include Guilliane Barre syndrome,
lupus, seizures, anaphylactic shock, chronic fatigue, paralysis, blood clots,
brain inflammation, blurred vision and blindness, convulsions, demyelinating
encephalomyelitis, multiple sclerosis, pancreatitis and various digestive
disorders. Last autumn a case of amyltrophic lateral sclerosis, better known as
Lou Gehrig’s disease, was reported. And a recent 2010 issue of the Journal of
Child Neurology investigated the case of a 16-year old girl going blind
following vaccination, a secondary symptom to multiple sclerosis. In her January
2010 article on Vactruth.com, “Website Documents Over 300 Gardasil Horror
Stories,” Christina England, a journalist monitoring the politics and science of
the HPV vaccines, relates the case of an employee at a large hospital who
commented on the 1,000 plus girls who are manifesting psychotic symptoms for no
apparent reason other than being vaccinated with Gardasil. Nevertheless, the
federal health agencies remain mute and dumb, and the CDC and the FDA continue
to stand by their masters at Merck and preach their faith in Gardasil as “safe
and effective and the benefits outweigh the risks.”

One would
expect that vaccine makers would undertake special precautionary measures when
conducting clinical trials for women who are undergoing hormonal changes, such
as premenstrual changes during puberity and during various stages of pregnancy.
The effects that Gardasil has on young girls entering sexual maturity remain
unknown. The principle investigator for Gardasil’s clinical trials, Dr. Diane
Harper, has publicly stated that no efficacy and safety trials for any of the
HPV vaccines were conducted on girls under the age of 15 years. Neither were
trials conducted to determine Gardasil’s safety on pregnant women.

Dr. Suzanne
Garland at the Royal Women’s Hospital in Melbourne published a study in 2009
issue of Obstetrics and Gynecology showing a “higher rate of congenital
abnormalities in infants were noted in pregnant women who received the vaccine.”
A second study, according to Christina England, found that there were slightly
higher fetal deaths and rare cases of central nervous system malformations and
neural tube defects in vaccinated pregnant women. Yet these kinds of studies
only convince us of the seriously flawed and limited clinical trials conducted
by Merck, and further confirms growing criticisms of the systemic failure in the
FDA’s approval process because of the millions of dollars the agency receives
from the pharmaceutical cartel to expedite vaccine and drug launches and to
require only the minimal of efficacy and safety information for approval.

Fortunately, the seriousness of HPV vaccination is becoming more apparent, via
the efforts of the National Vaccine Information Center, NaturalNews.com,
Mercoloa.com and the Progressive Radio Network, and concerns are being raised
within the practicing medical community and among parents. For example, the
otherwise pro-Big Pharma Journal of the American Medical Association
(JAMA) printed an article in 2009 stating that “the rate of serious adverse
events [of Gardasil] is greater than the incidence rate of cervical cancer.”
Given the high prestige of JAMA, this alone should be a sufficient warning to
avoid HPV vaccines at any cost.

Once a
vaccine is administered, the risk for potential damage cannot be recalled. It is
not like returning your Toyota to avoid the possibility of a mechanical failure
in the future. And the length of time a serious adverse effect might occur from
Gardasil remains unknown. Christina Tassell, a 21 year old National Honor
Student died in her sleep a couple days after receiving Gardasil. There was no
way the vaccine could be returned to her pediatric salesman after symptomatic
complications began to surface.

Since
Gardasil is administered in a series of three shots, adverse effects may occur
after the second or third vaccination, or even months afterwards. One mother
shared the condition of her 15-year old daughter who two months after receiving
her second vaccination began having seizures and complete memory loss. The mom
writes, “her other symptoms were hair loss, joint pain, severe headaches,
stomach pain and insomnia. When she did sleep, she would have seizures for
hours. We have taken her to numerous doctors but they have no idea what is wrong
with her. She continues to struggle on a day to day basis and is on the 504
Disability Plan at school”

So where is
the media in reporting on this Big Pharma-created medical catastrophe? Where
are the New York Times and Rupert Murdock’s media empire? Why aren’t our
health officials at the FDA, the CDC and Secretary Kathleen Sebelius at the HHS
taking precautionary measures, and why aren’t our elected officials on the Hill
demanding a Congressional investigation for a product threatening our daughter’s
lives and health that is greater than handing the family’s Toyota’s car keys
over to a teenager?

According
to Cindy Bevington, after she investigated the reasons why the New York Times
and the Associated Press are failing to report on the medical fraud that is so
clearly evident with HPV vaccination, she found people with the Associated Press
married to persons at Medscape and WebMD, two of the most popular medical and
drug information resources funded by Merck and GlaxoSmithKline. In addition,
James Murdoch is on the Board of Directors of GlaxoSmithKline, and Reuters’ CEO
sits on Merck’s board. “So of course the mainstream media aren’t going to report
it,” Bevington remarked.

But what is
worse and should instill greater outrage is that we are not dealing with a
pharmaceutical company with a relatively clean and innocent record—if such a
pharmaceutical entity actually exists—but we are facing Merck. In the case of
Toyota, there is reason to consider the automaker a first time offender. Until
the recent recall, Toyota had a near unblemished reputation for manufacturing
safe, reliable and popular vehicles for many years.

Merck on
the other hand has proven itself to be a notorious repeat offender. One would
expect that any drug maker steeped in a well-documented record of criminality
and fraud would immediately raise a red flag to federal health officials when
one of its products shows every indication of threatening the health and lives
of young American girls over the course of four years. Usually when a crime is
committed, repeat offenders are among the first to be investigated.

There
should be no hesitation in viewing Merck as the pharmaceutical industrial
complex’s most dangerous serial killer. Vioxx alone accounted for over 44,000
deaths and 120,000 serious medical injuries behind a trail of deception and
corporate cover-ups by withholding clinical information and documents confirming
Vioxx’s adverse effects. The company has been charged with intentionally hiding
the liver-damaging effects of its cholesterol drug, and intentionally
withholding the release of clinical data that revealed failures of another
cholesterol product. It has dumped vaccine waste and toxic chemicals in water
supplies. In 2008, it paid out $650 million for over-billing Medicaid. An
Australian civil suit has been filed against the company for publishing fake
medical journals; the Australasian Journal of Bone and Joint Medicine and
six others were simply phony surrogates for Merck advertising. Finally, the drug
giant was caught in a huge scheme of scientific fraud when it was discovered
that in-house writers were secretly being used to compose so-called
“independent” studies to support their research in peer-reviewed medical
journals.

However, we
should never underestimate the depth of Merck’s pockets and its power and
influence to persuade our federal regulators and elected officials to comply
with its financial bidding and lobbying demands. Clearly Merck is a leader in
the pharmaceutical cartel and a major force in the drug lobbying industry, if
not the entire American medical regime.

In the
shadows of Merck’s lawsuits and payouts, Merck has been in dire need of a
blockbuster drug. In order to position itself as the first to bring an HPV
vaccine to market, Merck commenced with a marketing campaign founded upon
misinformation and deception. It hired the world’s largest advertising master of
deception, the PR monster firm Edelman, best known for its early misinformation
campaign for its client R.J. Reynolds on behalf of the tobacco industry. Another
major Edelman client is Pharmaceutical Research and Manufacturers of America
(PhRMA), the principal lobbying organization for the pharmaceutical industry
that helped leverage Obamacare to care more for Big Pharma’s revenues and
shareholder interests than the health of the nation’s citizens. According to
Bloomberg News, Merck spent over $840,000 to infiltrate the internet with
information leading to the launch and advertising of Gardasil to parents of
daughters and young adult women. Their intention was primarily twofold. First,
it was necessary to educate the American public about the dangers HPV as the
single leading cause of cervical cancer. And second, it was not in Merck’s
commercial interests to offer the nation with factual statistical science that
would guide parents to make informed decisions on whether to have their
daughters vaccinated or not; rather it was a disinformation campaign,
piggy-backing on previous success campaigns related to STDs and HIV, to instill
fear about a dreaded HPV killer, disguised in the veneer of being a distinctly
“sexually transmitted” viral disease.

This is how
the mother of Britanny Bell understood the ads about Gardsil and how she was
persuaded to relieve her fears by having her 12-year old daughter vaccinated.
Two months after receiving the vaccine, the former cross country runner
collapsed and now suffers paralysis in her legs. And how did Merck respond to
the growing number of incidences of paralysis in vaccinated girls? One Merck
spokesperson, responded to the media with expected corporate sociopathic logic:
since paralysis is not one of Gardasil’s adverse effects and it is not a listed
complication on the package insert—so the logic goes—the tragic events of
paralysis could not be related to Gardasil.

Since the
FDA’s standard for vaccine approval is so remarkably low, and there is no
financial reason or incentive for the vaccine industry to raise the bar on
conducting safety trials, serious vaccine adverse effects may take a while, even
years, to be officially investigated and confirmed. For example, ever since
Gardasil’s 2006 launch upon the public, there have been incidences of girls
having seizures. At the time, seizures were not listed as an adverse effect on
the vaccine’s product packaging and labeling. As seizure rates increased, Merck
eventually conceded to include it; but it was not until mid-2009 that they did
so, and during the previous three years pediatricians were blind and unknowingly
administering a vaccine related to seizures.

In the wake
of all the evidence confirming Gardasil’s serious life-threatening risks, how
are we to understand Merck’s adamant stance on the health benefits of its
vaccine, and the CDC’s and FDA’s commitment to HPV vaccines being “safe and
effective and the benefits outweigh the risks?” How scientifically valid are
these claims?

Cindy
Bevington is an investigative reporter who won acclaim for bringing attention to
the whistleblowing facts behind the HPV vaccines after interviewing Dr. Diana
Harper. During Bevington’s interview, Dr. Harper stated that “giving [the HPV
vaccines] to 11 year olds is a great big public health experiment.” Dr. Harper
is highly qualified to know the truth. She is a world expert in HPV virus,
having studied over 100 strains of this particular virus for 20 years. During
her professorship at Dartmouth School of Medicine, she was the principal
investigator for the clinical trials conducted for both Merck’s Gardasil and a
competitor vaccine, Cervarix, manufactured by GlaxoSmithKline, which was
approved in the US in late 2009. As the principal investigator, Dr. Harper was
responsible for the research, the recruiting of participants into the trials,
and the review of the clinical data for interpretation and publication.

First, in
contradiction to what we are being told through Merck’s advertising campaign,
Gardasil is not a cancer vaccine. There are no clinical studies whatsoever
proving that the vaccine prevents cancer at all. In fact the National Institutes
for Health states that the virus does not lead directly to cervical cancer. What
HPV does is influence cellular abnormalities, which if not detected via a pap
smear, could potentially turn cancerous. However, according to Dr. Harper, 70
percent of HPV infections resolve themselves in one year, and 90 percent resolve
themselves in two years without treatment. A recent study from New Zealand
indicates that 95 percent of HPV infections naturally disappear due to the
body’s immune system.

This is not
to suggest HPV infections are rare; in fact, 80 percent of women by the age 50
will have been infected with one of many strains. Gardasil only protects against
two of those strains—types 16 and 18—that account for approximately two-thirds
of cervical cancers. But HPV infections are not in any way associated with the
alarm and fear promulgated by Merck and our federal and state health agencies.
In fact, HPV infection is easily treated and cervical cancer prevention has been
statistically proven to be more effective with regular pap smear exams instead
of a vaccine. Dr. Anne Szarewski at the Cancer Research UK conservatively told
the British newspaper The Telegraph that “a [pap smear] screening program
is as effective as a vaccination program;” equally important, nobody ever died
or was physically disabled from a pap smear, which is also far cheaper and more
cost-effective. Cindy Bevington has further reported that the vaccine makers’
own clinical studies show that unless a girl is tested negative for HPV at the
time of her vaccination, HPV vaccination can actually backfire and increase her
risk of a current infection progressing towards cervical cancer.

During a
special April 29 Progressive Radio Network broadcast about the dangers and
politics of Gardasil and GlaxoSmithKline’s Cervarix HPV vaccine, Bevington
outlined Merck’s and the CDC’s fabrication of a mythology to instill fear in
parents leading to mandatory vaccine enforcement. What is not being told to the
public, according to Bevington’s research, “is that anyone can get HPV. It is
not a sexually transmitted disease even though that’s what the government tells
you and that’s the first thing on the CDC’s website. Professional journal
articles and studies have shown documented cases of babies testing positive for
HPV as well as nuns who have never had sex, as well as adolescent boys who
happen to have it under their fingernails. That is because HPV is transmitted
via the skin. [Merck’s and the CDC’s] vaccine campaigns simply highlight the
easiest most common mode of transmission, which is sexual.”

The
question of whether or not girls as young as 9 years old, which is the minimum
age approved by the FDA, should receive the vaccine is the most disturbing. Dr.
Harper has categorically stated that no efficacy or safety trials have ever been
conducted on girls under age 15. Furthermore, young girls don’t get cervical
cancer. So is there any credible rationale for vaccinated girls at such a young
age other than increasing revenue streams?

In her
lecture to the 2010 Vaccine Conference sponsored by the National Vaccine
Information Center, Dr. Harper lectured that the safety issues with Gardasil are
so serious that the rate of serious adverse events is greater in the US than the
incidence rate of cervical cancer. The incidence of cervical cancer is so low,
there is almost no supporting evidence to conclude massive vaccination would
lower the rate. In her analysis of Harper’s findings, Bevington states, “in the
US to even touch cervical cancer rates in this country, you would have to
vaccinate every single 11 year old in the US every year for 70 years to even
drop [the cervical cancer rate] by one percent.”

In 2007,
almost every state had legislation filed to mandate the HPV vaccine. It is
rather extraordinary that so many states would have state officials in unison
calling for mandatory vaccination. Well, it might appear rather odd and
remarkable until the extent to which Merck’s greedy tentacles reach the fringe
corners of state governments are fully recognized.

Women in
Government is a nonprofit organization with a stated mission to bring elected
women state legislators and business leaders together. In reality WIG is little
more than a well-funded shill for the pharmaceutical and energy industries. Over
50 percent of its corporate sponsors are Big Pharm firms, including the two HPV
vaccine manufacturers Merck and GlaxoSmithKline. The organization also hosts a
“Business Council”, a six member advisory group consulting state women
legislators about critical business issues. Three of the six Council members
represent the pharmaceutical industrial complex, and not surprisingly these
include Merck’s Executive Director of Health Policy and GlaxoSmithKline’s
Director of Public Policy. The third drug member is Digene Corporation’s VP for
Women’s Health. Who is Digene, a firm very few people have heard of? It is
certainly not one of the larger multi-national pharmaceutical firms among WIG’s
corporate sponsors. It turns out Digene is the company that manufactures
Gardasil.

The WIG’s
recent report, “A Roadmap for Success: The State of Cervical Cancer Prevention
in America 2010,” which is being disseminated through state health departments
and women’s health organizations, is nothing more than a fidgeting and
arrangement of data about the severity of cervical cancer and rates of
infections leading to the conclusion that vaccinating all girls in the US will
eradicate HPV infection.

Individual
state initiatives to mandate the HPV vaccine can be traced back to WIG. Texas
governor Rick Perry is perhaps the most rabid among state governors seeking
mandatory vaccination. Perry’s former chief of staff is now a Merck lobbyist and
Perry himself received Merck donations for his reelection campaign. The former
chief’s mother, state representative Diana White Delisis is WIG’s state
director. Now that the FDA approved Gardasil for males from 9 to 26 years of age
to protect against genital warts and extremely rare penile and anal cancers, the
Texas Medical Association voted this month in favor of vaccinating young boys as
young as 9 years of age.

Efforts are
still being made in some states to mandate HPV vaccines. In New York, Liz
Kreuger, a leading voice in WIG, sponsored a State Senate bill for mandatory
vaccination. Fortunately that bill was placed on hold last February.

WIG,
however, is not the only state legislative organization that has been won over
by Merck and GlaxoSmithKline. The National Foundation for Women Legislators and
the National Conference of State Legislators each include the two HPV vaccine
makers as sponsoring corporate members. Along with WIG, Merck’s viral propaganda
has infected almost every state health department.

In the June
2008 issue of the Journal of Law, Medicine and Ethics, three scholars
representing Johns Hopkins Institute of Bioethics, George Washington School of
Medicine, and Georgetown University’s Law Center determined that the evidence
for the benefits of HPV vaccines on public health provides no rationale
whatsoever for making it mandatory. In fact, such a mandate would be unethical
and unconstitutional.

The
consequences of Merck’s actions and the actions of the corporation’s zombies in
government health agencies and organizations, such as WIG, to promulgate
scientific falsehood has had an immense impact on seducing local health
facilities, hospital staffs, physicians and pediatricians. The efforts to
mandate unproven and questionable vaccines, such as Gardasil, border on medical
fascism. One story of a terrible casualty illustrates how far Merck’s marketing
campaign has reached:

One mother
reports on the website Medications.com a story of her 13-year old daughter who
was otherwise a physically active and healthy daughter until she became
partially paralyzed after receiving a Gardasil vaccination. Her leg muscles
shrank; her feet contorted as her muscular deterioration and nerve damage
increased. She was taken to the best medical facilities: Case Western Hospital,
the hospitals at Stanford University and the University of California at San
Francisco, John Hopkins and others. Then the mom shares some information
indicative of Merck’s marketing success. “This has been a very long, hard road
and battle for my child. All because of vaccines. I was not fully informed of
possible deaths or serious side effects linked to Gardasil. I did not give
written consent; I was told this was practically mandated in other states and
would soon be mandatory for all school girls age 11-12years old. I was told it
was a good vaccine and led to believe I would not have to worry about my
daughter having cervical cancer some day.”

Merck’s
aggressive lobbying of federal and state officials has paid off. In 2008,
Gardasil became one of the top five selling vaccines allowing the drug giant to
cash in on $2.7 billion in sales. It is also the most expensive vaccine on the
market, costing almost $400 for the series of three inoculations. Medical writer
Judith Siers-Poisson has called it the “financial equivalent of the Holy Grail
for the pharmaceutical company.”

It is
highly unlikely that Merck will ever reconsider its marketing assault to
vaccinate the world’s female population. Gardasil is already approved in over
100 countries. It is much easier for Merck to do what it has done best and has
had the greatest success: cover-up their product’s health risks and dangers,
withhold clinical information, continue to ferret federal health officials and
governments, and simply pay a fine if and when the company gets caught for its
criminal behavior. Then it is back to business as usual to find another
blockbuster drug to repeat their strategy all over again.

Even if the
US government and its health officials don’t give a damn about the physical
health and well-being of its citizens, and particularly its children, there are
some countries that actually care population’s health. India commenced with a
2-year study to determine the efficacy of Merck’s Garadsil. Last April, the
nation’s health ministry suspended the study after 4 girls died and 120 serious
complications were reported. To date, India has no plans to launch the vaccine
on its young girls and women.

In Bhutan,
Merck promised free Gardasil for the tiny Himalayan nation’s female population.
On May 14, the Bhutan Observer reported that the country’s Drug
Regulatory Authority, after witnessing events in India, ordered a halt to the
vaccine until greater proof of safety can be produced. In Spain, the government
recalled Gardasil after two serious hospitalizations occurred following
inoculation. Yet in the US, we have thousands of Gardasil casualties, and nobody
in government is doing anything about it.

There is also some additional good news. Gardasil is now the mostly commonly
declined vaccine, by 56 percent over other vaccines, among parents. And the
professional journal Pediatrics has reported on a 2009 survey showing
that 1 out 8 parents have refused at least one Gardasil vaccination recommended
by their physicians or pediatricians. Therefore, we are witnessing the success
of educating people about the dangers of vaccination and exposing the lies and
fraud of the vaccine industry as the best chance available to preserve the
health of children and young people.

The bad
news is Merck is relentless in its pursuit for profits and no longer wants to
limit Gardasil as a predatory revenue on girls and woman used as crash test
dummies. On the very day the FDA approved GlaxoSmithKline’s HPV vaccine Cervarix
in the US, it also approved Gardasil for boys 9 to 26 years old for genital
warts. In May, Merck started marketing the vaccine towards America’s sons.
Again, it is fueled under the deceptive advertizing that genital warts are
sexually transmitted. And the FDA simply continues mimics Merck’s information
campaign. The FDA’s director Dr. Karen Midthun in the agency’s press release
states, “This vaccine is the first preventative therapy against genital warts in
boys and men ages 9 through 26, and, as a result, fewer men will need to undergo
treatment.” The caveat of facts not mentioned by the FDA is that boys infected
with HPV rarely have symptoms, and as with girls and women, infections disappear
rapidly and naturally.

We are now
faced with a paradoxical issue. Do we continue to create ever more vaccines,
always with the assumption that their safety and efficacy have been proven and
that there is no limit to how many of these vaccines can be introduced into a
human body. Or do we for the first time investigate objectively by a high
scientific gold standard, independent from the vaccine manufacturers and the
federal agencies, the long term safety and efficacy of individual vaccines and
and vaccines used in combination? However, we must be realistic. We are
witnessing the power of Wall Street lobbyists acting for the banking industry
who control almost every aspect of the financial reform bill. Hence there will
be no real structural reform whatsoever. We saw the pharmaceutical and
insurance industries’ and their lobbyists control the healthcare debate. Again,
the final bill represents no actual reform, virtually no preventative and
regulatory measures to lessen the incidence of diseases. We observed the energy
cartels and their lobbyists meeting secretly with Dick Cheney to assure the
barons of coal, oil and nuclear energies can act on their own behalf without
government interference. So the reality is that standing in the way to thwart
any legitimate effort to evaluate vaccine efficacy and safety is once again the
pharmaceutical industrial complex, their thousands of lobbyists, and the
industry’s serfs serving as heads of our regulatory health and oversight
bodies.

The
pharmaceutical financial game will continue, and injuries and deaths will
continue to rise.

What chance
is there then for scientific truth and ethical responsibility to protect
citizens to emerge?

Richard Gale is the
Executive Producer of the
Progressive Radio Network and a former Senior Research Analyst in the
genomic industry.

Dr. Gary Null is the
host of the nation’s longest running public radio program on nutrition and
alternative medicine, and a multi-award-winning director of progressivedocumentary films, including Vaccine
Nation (2008) and Autism: Made in the USA (2009)